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Pdf 282.12 K Archives of Research Firecracker Injuries During Chaharshanbeh Soori Festival In Iran: a Case Series Study 1, 2 2 2 Hamid Reza Hatamabadi , Ali Tabatabaey , Kamran Heidari , Mohamad Karim 2, * Khoramian 1 Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran 2 Emergency Department, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran *Corresponding author : Mohamad Karim Khoramian, Emergency Department, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel.: +98-2173432380, Fax: +98-2177557069, E-mail: [email protected]. ABSTRACT On the last Wednesday of every year Iranians celebrate the sanctity of fire in the annual festival of Chaharshanbeh Soori. Each year many cases of firecracker-related injuries (FRI) are reported during this festival. The aim of this study was to assess the pattern of injuries and the frequency of disabilities during this period. In 2011, a cross-sectional study was conducted at the emergency departments (EDs) of three educational hospitals in Tehran, to assess the extent and demographics of FRI. The age and sex of the patient, type of referral to the hospital, type of injury, its region and treatment process were recorded for each patient by the physicians. Data were analyzed by SPSS version 20. Thirty-five patients suffering from FRI were admitted to the hospitals during the festival. The majority of patients were under 30 years-old and most of them were male (83% male and 17% female). The injuries were mostly lacerations and cuts (n = 17, 49%) and scratches (n = 12, 34%). One patient suffered amputation. The most common site of the injuries were the hands (n = 13, 37%) followed by the face (n = 10, 29%). There were 10 patients (29%) with more than one site of injury. Twenty-one patients were hospitalized, 12 patients (34%) received outpatient treatment and two patients were referred to other hospitals. There are still many victims during Chaharshanbeh Soori festival despite efforts and legislations by the government. Education and raise of awareness among people especially for youth are the most important ways to prevent and reduce Red Wednesday injuries. Keywords: Wounds and Injuries; Emergency Medicine; Prevention and Control Copyright © 2013, Kashan University of Medical Sciences.; Published by Kowsar Article type: Case Report; Received: 23 Nov 2012; Revised: 15 Jan 2013; Accepted: 29 Jan 2013; Epub: 01 Jun 2013, Ppub: Spring 2013 Implication for health policy/practice/research/medical education: This title has been studied in order to raise awareness for such injuries in the government to prevent and reduce their recurrence. Please cite this paper as: Hatamabadi HR, Tabatabaey A, Heidari K, Khoramian MK. Firecracker Injuries During Chaharshanbeh Soori Festival In Iran: a Case Series Study. Arch Trauma Res. 2013; 2(1): 46-9. DOI: 10.5812/atr.9250 Copyright © 2013, Kashan University of Medical Sciences.; Published by Kowsar This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which per- mits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Firecracker Injuries During Iranian Festival Hatamabadi HR et al. 1. Introduction was 24 years old (SD 12), ranging from 3 to 72 years old. Most patients were below 30 years old and were predomi- One of the annual Iranian traditions is the celebration nantly male (83% men, 17% women). Sixteen patients had of Chaharshanbeh Soori. Held on the final Wednesday of been brought to the hospital by emergency medical ser- the year, Chaharshanbe Soori or Red Wednesday is among vices (call to 115) and 15 patients (43%) were admitted as the celebrations leading up to the Persian New Year or outpatients. The information regarding type and site of Nowruz on the spring Equinox. The word Chaharshan- Table 1 injury is summarized in . There were 10 patients beh means Wednesday and the word Soori means Red. (29%) with more than one injury site. Twenty-one patients The day is marked by different festivities and ceremonies required hospitalization, 12 patients (34%) were treated as celebrating the sanctity of fire, wishing away disease and outpatients, and two patients were referred to other hos- disasters and wishing for health and good luck for the pitals for further diagnostic and treatment services. upcoming year. This ceremony dates back to many centu- ries ago (1). The fire in the perspective of Iranians is a sym- Table 1. Distribution of Injury Sites and Types bol of something clear, clean, refreshing, and healthy. At Demographic Features No. (%) Chaharshanbeh Soori people make a fire and jump over it while chanting a ritual song. Since ancient times, in Gender addition to kindling fire, the celebration includes sing- Male 29 (83) ing songs, dressing up and enjoying sweets and nuts. Female 6 (17) Yet unfortunately, in recent years the ceremony of Red Type of admission Wednesday has been the source of many accidents and mishaps. What has gained the attention of citizens espe- Emergency Medical Services 16 (51) cially the youths and teenagers in recent years, is creating Outpatient 15 (49) noise and frightening sounds through the explosion of Type of injury flammable materials which are not less dangerous and destructive than explosive materials (2, 3). This issue has Lacerations 17 (49) turned this tradition into a source of unwanted events Scratches 12 (34) and unpleasant accidents which threaten lives and prop- Burns 5 (14) erties. Firecracker-related injuries during the festival Abrasions 5 (14) have been reported in the past (4, 5). This study has been conducted to report on the patient load induced by the Fractures 4 (11) festival on general hospitals in Tehran, rather than spe- Amputations 1 (3) cific burns or eye injuries. Unlike most of the previous Injury site reports, this study is set in three general hospitals and Hands 13 (37) focuses on the injuries reported on the day of the festival Face 10 (29) itself. This research can be an effective step in reducing the incidence of injuries of Red Wednesday. Eyes 7 (20) Torso 5 (14) 2. Case Report Head 4 (11) This cross-sectional study was conducted in the Emer- Ears 2 (6) gency Departments (EDs) of Imam Hossein, Shohada Haftom Tir and Shohada Tajrish hospitals in Tehran dur- 3. Discussion ing the 2011 Charshanbeh Soori day and night. The age, sex, type of referral to the hospital (call to emergency Numerous publications have reported on the misuse medical services (EMS), from other hospitals, outpatient), of firecrackers as the main cause of injuries in various type of injury (Abrasion, scratch, amputation, burn, ceremonies held all over the world (6-10). Firecrackers breakage, laceration and cut), sites of injury (ear, eye, are largely used among people during festivals for their face, leg, hand, head, neck, body), type of treatment (out- sound, spark, shining and sudden explosion while light- patient, hospitalization, referal to another hospital) were ing up the celebration mood. They are used during nu- recorded for each patient with FRI by the physicians. SPSS merous festivals all over the world such as Tihar in Nepal, version 20 was used to analyze the data and to perform Ashura day in Morocco, Hari Raya in Malaysia, Day of statistical analysis where relevant. A P < 0.05 was con- Independence and Halloween in the USA, Bastille Day in sidered statistically significant. Discrete variables were France, Spanish Fallas and New Year's Day in Guatemala expressed as percentages. Continuous variables were and China, Guy Fawkes Night in the UK and many other reported as means and standard deviations. There were festivals in the world (7, 8, 11). Iran is a large country with 35 firecracker-injured patients admitted during Char- a population of 70 million people. Despite a lot of govern- shanbeh Soori day and night. The mean age of patients ment efforts there are many victims during Charshanbeh 47 Arch Trauma Res. ;2(1) Hatamabadi HR et al. Firecracker Injuries During Iranian Festival Soori festival every year (2). In the years 1980 to 1989 ap- his lifetime (22). With that in mind, in the case of Red proximately 10000 individuals from the United States Wednesday for the final Wednesday of 2010, more than suffered injuries resulting from firecrackers; while the 130 people who suffered eye injuries referred to the Eye United States of America during the years 1990 to 2003 Specialist Hospital, Tehran University from which thirty alone had 85800 injuries resulting from firecrackers (12). people were at risk of blindness. According to the statis- In the UK, the highest number of injuries were reported tics of Iran’s Ministry of Health, in 2009, 1928 patients in- during Halloween (13). A total of 4447 patients with fire- jured from Red Wednesday referred to hospitals whereas cracker-related injuries received medical attention dur- 1817 cases were referred in 2008; resulting in a 6% increase ing the two days around the New Year celebrations at (16). In 2009, about 1601 cases of emergency admissions Denmark Hospitals (14). Greece has not been safe against for hospitals related to the events of Red Wednesday from firecracker- related injuries either. Annually from every which about 487 individuals received treatments on site, 1000 child, 7 face these injuries, 70% of which occur in the and 114 individuals were dispatched to other hospitals; age group of 10 to 14 years old (15). So, we can conclude from this figure 1232 people were male and 369 people that this type of injury affects both developed countries were female (16). According to the Department of Disas- and developing countries. Imam Hussein and Shohada ter Prevention for the Ministry of Health, the age group Haftom Tir Hospital are trauma center hospitals in Teh- of 15 to 19 years old, with 21.9 % and the age group of 20 to ran and on the Red Wednesday of 2011 they admitted 35 24 years old with 19.5 % in total contributed to 41 % of the firecracker-related injuries.
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